Remote monitoring system for older adults at risk for complications: a scoping review

Introduction: Aging populations and the increasing incidence of chronic diseases are placing additional pressure on healthcare systems. Remote monitoring systems (RMS) have emerged as a solution for improving remote healthcare efficiency and monitoring complex elderly patients. However, telemonitoring services in elderly care are still in their infancy, and their effectiveness remains unproven, with the potential for context-dependent variability. To bridge this gap, we conducted a scoping review to understand the current state of RMSs for elderly individuals at risk for complications, and their potential impact on healthcare service use, elderly's quality of life, and cost-effectiveness. Methods: Following the PRISMA-ScR guidelines, data were gathered from PubMed, Scopus, and Google Scholar databases using predefined keywords, from 2010 onwards. Only English peer-reviewed studies that met the eligibility criteria were retained. Results: A total of 1,576 articles were initially identified. After removing duplicates and screening titles and abstracts, 47 articles were eligible for full-text assessment. Of these, 18 articles were included in the final analysis. Multiple RMSs have been identified and used for elderly patients with complex chronic conditions and a high risk of complications. Such systems typically involve telemonitoring devices, integrated or not with health questionnaires, supported by an automated alert system led by a healthcare professional, usually a nurse, who collaborates with different healthcare structures. The evaluation of RMSs effectiveness was primarily based on health service utilization—particularly hospitalization, emergency room visits and length of hospital stay—followed by quality of life and cost-effectiveness. Our findings support the promising impact of RMSs on reducing hospitalization for at-risk elderly individuals, especially the unplanned hospitalization, improving quality of life, and its cost-effectiveness. Conclusion: This review outlines multiple RMSs used for elderly individuals at risk for complications. Although the effectiveness of RMSs may depend on the content and level of responsiveness, our review underscores the necessity for further empirical research into telemonitoring interventions to fully understand their impact on elderly health outcomes and healthcare systems resources